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Medical Coding and Documentation Requirements Quiz

#1

Which code set is used to report medical procedures and services?

CPT
Explanation

Standard coding system for reporting medical procedures and services.

#2

What does 'E&M' stand for in medical coding?

Evaluation and Management
Explanation

Refers to the process of evaluating and managing patient care.

#3

What is the purpose of using modifiers in medical coding?

To provide additional information or indicate special circumstances
Explanation

Modifiers offer extra details or signify unique conditions in coding.

#4

Which organization is responsible for maintaining the CPT code set?

American Medical Association (AMA)
Explanation

AMA oversees and updates the Current Procedural Terminology (CPT) code set.

#5

Which of the following code sets is used for reporting diagnoses in inpatient hospital settings?

ICD-10-PCS
Explanation

Specific code set for reporting inpatient hospital diagnoses and procedures.

#6

What does 'HCC' stand for in the context of medical coding?

Hierarchical Condition Categories
Explanation

HCCs are used to predict healthcare costs based on patient conditions.

#7

Which of the following is NOT a component of E/M (Evaluation and Management) coding?

Coordination
Explanation

Coordination is not a direct component of E/M coding.

#8

What is the purpose of the 'NCCI' (National Correct Coding Initiative) in medical coding?

To prevent improper coding combinations
Explanation

NCCI aims to avoid incorrect coding combinations.

#9

What is the primary purpose of medical documentation?

To provide evidence of medical necessity and quality of care
Explanation

Medical documentation serves as proof for the necessity and quality of healthcare provided.

#10

What is the purpose of the 'Global Surgical Package' in medical coding?

To bundle payment for pre-operative and post-operative care
Explanation

Ensures a single payment for all stages of a surgical procedure.

#11

Which entity assigns ICD-10-CM codes for diseases and conditions in the United States?

National Center for Health Statistics (NCHS)
Explanation

NCHS is responsible for assigning ICD-10-CM codes in the U.S.

#12

What does 'ABN' stand for in medical billing?

Advance Beneficiary Notice
Explanation

ABN is a notice provided to inform patients of potential non-covered services.

#13

Which organization developed the CPT (Current Procedural Terminology) code set?

American Medical Association (AMA)
Explanation

AMA is the developer and maintainer of the CPT code set.

#14

What does 'HIPAA' stand for in healthcare?

Health Insurance Portability and Accountability Act
Explanation

HIPAA is a federal law ensuring privacy and security of health information.

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